Health and Wellness Coaching With the Practice: Who It Helps

Health and wellness coaching at Dr. Lewis's practice is provided by Shoshana Silverman Belisle, NBC-HWC, a certified integrative wellness coach who works on the same team as the practice's psychiatrists, nurse practitioners and therapists. Coaching helps most when you know what you want to change in daily life, such as sleep routines, movement, eating patterns or stress habits, and want structured support and accountability to make it stick.

Coaching is not therapy and not medical treatment. It does not diagnose, prescribe or treat mental illness. This guide explains what the NBC-HWC credential means, where the line between coaching and therapy sits, who tends to benefit, what the research does and does not show, and how coaching fits alongside psychiatric care on one team.

What "NBC-HWC" means

NBC-HWC stands for National Board Certified Health & Wellness Coach. The credential is awarded by the National Board for Health & Wellness Coaching (NBHWC), and the certifying exam is developed and managed with the National Board of Medical Examiners, which also co-sponsors the U.S. Medical Licensing Examination with the Federation of State Medical Boards.

To sit for the board exam, a coach must:

• Complete an NBHWC-approved training program.
• Log 50 coaching sessions that meet the board's eligibility rules, after passing a skills assessment in that program.
• Hold an associate's degree or higher from an accredited institution, or meet the board's alternatives, such as 4,000 hours of work experience.

People use the title "coach" with very different levels of training, so board certification is one of the few external checks a consumer has. It shows the coach completed approved training, supervised practice and a standardized exam. It does not make the coach a clinician.

Where coaching ends and therapy begins

NBHWC's own scope of practice draws the line clearly. Acting on their own, board-certified coaches do not diagnose, interpret medical data, prescribe or de-prescribe, and they may not provide psychological therapeutic interventions or treatment, which NBHWC defines as efforts to remediate a diagnosed medical or mental health condition, with CBT, EMDR and DBT as examples. The same document says coaches may not give exercise prescriptions, recommend supplements or create meal plans.

What coaches do is described as being an accountability partner rather than a director. When working under the license of a qualified medical or allied health professional, a coach may support the implementation of that professional's treatment plan.

A longer comparison, with examples of which problems belong where, is in coaching, therapy or psychiatry: which kind of help you need.

Who coaching tends to help

Coaching suits people who are reasonably stable and know, at least roughly, what they want to do differently. Common examples:

• You and your prescriber or therapist have agreed that regular sleep and wake times, more daylight or more movement would help, and you keep not doing it.
• You are working on eating patterns, alcohol reduction or caffeine timing as part of a broader plan and want weekly check-ins.
• You are recovering from burnout and want to rebuild routines without overcommitting.
• You have a chronic physical condition and want help turning medical advice into habits.

Coaching is a poor fit, at least on its own, if you have untreated moderate to severe depression, active panic attacks, an eating disorder, thoughts of self-harm, or symptoms that make it hard to function day to day. Those need assessment and treatment first. Coaching can be added later as a support. If you are unsure, a conversation on the discovery call, described in how to start care with Dr. Lewis, will sort it out faster than guessing.

If you are thinking about suicide or are in crisis, call or text 988 (the 988 Suicide & Crisis Lifeline) or go to the nearest emergency room.

For adults with ADHD, executive-function coaching is a related but distinct service; see ADHD coaching vs therapy for what it can and cannot do.

What the evidence shows, and what it does not

The research on health and wellness coaching is growing but uneven. A 2023 systematic review and meta-analysis pooled 30 randomized trials with 8,662 adults living with chronic conditions such as type 2 diabetes, COPD, chronic pain, cancer and heart disease. It found that coaching improved quality of life at three months, with no significant effect at six, twelve or eighteen months. Depression scores improved at three, six and twelve months, with a smaller effect at twelve months than at three and six.

The authors rated the certainty of the evidence for most outcomes as low or very low, mainly because of risk of bias, differences between studies and imprecise results. In plain terms: coaching looks helpful for some outcomes in people managing chronic illness, the benefits may fade, and better trials are needed.

What the evidence does not show:

• That coaching treats depression, anxiety or other psychiatric disorders as a stand-alone therapy. The trials above were in people with chronic physical conditions, and coaching is not a substitute for evidence-based psychotherapy or medication.
• That any particular coaching program produces lasting change for everyone. Effects were strongest in the short term.
• That certification guarantees results. It is a training and competency standard, not an outcome measure.

How coaching fits with psychiatric care on one team

The practice lists coaching as part of its ongoing care alongside psychiatric evaluation and medication management, psychotherapy, lab testing, and nutrition and lifestyle psychiatry. The potential advantage of a coach on a clinical team is the hand-off: a prescriber or therapist can set the clinical direction, and a coach can help with the daily follow-through. That matches NBHWC's description of coaches supporting the implementation of a licensed professional's plan.

A worked example shows how the pieces divide. Suppose your prescriber suspects that irregular sleep is worsening your mood and agrees with you on a goal of a consistent wake time. The prescriber handles the diagnosis and any medication question. A therapist might use CBT techniques for the worry that keeps you awake. The coach helps you design a realistic morning routine, plan for the weekends that usually derail it, and check in weekly on what happened. If the coach notices that your mood is getting worse, the right move is to flag it back to the clinical team, not to change the plan.

Before starting coaching alongside other care, ask how the coach and your clinicians share information, and who you contact if something clinical comes up between sessions.

Questions to ask before you start coaching

• What would we work on in the first month, and how would we know it is working?
• How often are sessions, and are they in person or by video?
• Will the coach communicate with my prescriber or therapist, and with what consent?
• What happens if a clinical issue comes up during coaching?
• What does coaching cost, and is any of it reimbursable under my plan? (Coverage for coaching varies; check with your insurer.)

Bring these questions to the discovery call; the answers will tell you more about fit than any description of coaching in general.

What coaching sessions generally look like

Coaching formats vary, but board-certified coaching tends to follow a recognizable pattern. Knowing it helps you judge whether the sessions are doing their job.

1. Clarifying what you want. Early sessions focus on what matters to you and why, not on what the coach thinks you should change. A goal you chose is more likely to last than one handed to you.
2. Choosing a small, specific step. "Exercise more" becomes "take a short walk after lunch three days a week." The step should feel almost too easy.
3. Planning for obstacles. A good coach asks what usually gets in the way, such as late meetings, bad weather or low energy, and helps you plan around it in advance.
4. Reviewing what happened. The next session starts with what you actually did, without judgment. Missed steps are information, not failure.
5. Adjusting and building. Once a habit holds, you add the next step or raise the bar slightly.

Because the coach's role is to be an accountability partner rather than a director, you should leave most sessions having done most of the talking and having chosen your own next step.

Common mistakes when starting coaching

• Using coaching to avoid treatment. If low mood, anxiety or poor sleep is severe or getting worse, coaching should not delay an evaluation. It works best as a support to treatment, not a replacement for it.
• Setting too many goals at once. Changing sleep, diet, exercise and screen time in the same week usually means none of them sticks.
• Expecting the coach to supply the plan. Under NBHWC's scope, meal plans, exercise prescriptions and supplement advice are outside a coach's role. If you need those, they come from a clinician.
• Stopping when the first goal is met. Short-term gains from coaching may fade, so it is worth planning how you will keep a habit going once regular sessions end.
• Keeping coaching and clinical care in separate silos. If you see a prescriber or therapist, tell them you are working with a coach and what you are working on.

Signs coaching is working, and signs to step up care

The right-hand column does not mean coaching failed. It means something clinical may be getting in the way, and a prescriber or therapist should take a look. On a team with prescribers and therapists, ask how that hand-off works so you know what to expect.

Coaching and integrative psychiatry

Coaching fits naturally with the lifestyle side of integrative psychiatry: sleep, movement, nutrition patterns and stress. The practice has pages on lifestyle psychiatry and nutrition and mental health that describe the clinical side. The Health Strategy Session with Dr. Lewis ends with a decision about next steps, which can include lab testing, psychiatric care, coaching or the online program. If you want structured education rather than one-on-one support, the online course is a different option, covered in who the Bliss Protocol course is for.

How the practice handles coaching

At this practice, coaching is one of several services on a single team that also includes psychiatrists, psychiatric nurse practitioners and psychotherapists. Whether coaching can be used on its own or only alongside clinical care is a question to ask the team. The coaching page describes the approach, and the team page lists the coach and clinicians. To start, use the free discovery call to ask whether coaching alone or combined care makes more sense for your situation. Fees are on the insurance and payment page. The Choosing Psychiatric Care guide lists every starting point, and choosing your starting point compares them side by side.

Frequently asked questions

Is a health coach the same as a therapist?

No. Board-certified health and wellness coaches do not diagnose, prescribe or provide psychological treatment such as CBT or DBT. They help you turn goals into habits and stay accountable.

Can a coach tell me which supplements to take?

Under NBHWC's scope of practice, coaches may not recommend supplements or create meal plans. Those questions belong with a clinician.

Can I see the coach without seeing a psychiatrist?

Ask on the discovery call. The practice lists coaching as one of its services, and the Health Strategy Session can end with coaching as a next step.

How do I check that a coach is board certified?

The credential appears as NBC-HWC after the coach's name. Ask the coach for certification details, and contact NBHWC (nbhwc.org) if you want to confirm them.

Will insurance pay for health coaching?

Coverage for coaching varies by plan. Ask your insurer directly, and ask the practice whether a superbill is available for coaching sessions.

What if coaching brings up something that feels like more than a habit problem?

Tell the coach, and tell your therapist or prescriber if you have one. Ask at the start how the coach passes concerns to the clinical team so a therapist or prescriber can assess them.

Sources

1. National Board Certified Health & Wellness Coaches. National Board for Health & Wellness Coaching, 2026. nbhwc.org
2. Get Board Certified. National Board for Health & Wellness Coaching, 2026. nbhwc.org
3. Scope of Practice. National Board for Health & Wellness Coaching, 2026. nbhwc.org
4. The impact of health and wellness coaching on patient-important outcomes in chronic illness care: A systematic review and meta-analysis. Patient Education and Counseling (Boehmer KR et al.), 2023. pmc.ncbi.nlm.nih.gov

Educational information, not medical, tax or legal advice. Decisions about diagnosis, medication and treatment belong with a clinician who knows your history.